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Anteayer Journal of Advanced Nursing

Systematic Review and Meta‐Analysis of Post‐Stroke Delirium Risk Prediction Models

ABSTRACT

Aim

To systematically review published studies on the post stroke delirium risk prediction models; and to provide the evidence for developing and updating the clinically available prediction models.

Design

Systematic review.

Data Sources

Systematically searched studies on 10 databases, which were conducted from inception to 9 January 2025. The studies of post-stroke delirium risk prediction models were included.

Methods

Extracted the data from the selected studies. The Prediction Model Risk of Bias Assessment Tool checklist was used to evaluate the risk of bias of the models. The meta-analysis of model performance and common predictors was performed by Revman 5.4 and Medcalc.

Results

A total of 12 studies were included, and 21 risk prediction models for post-stroke delirium were constructed. The combined effect size of area under the receiver operating characteristic curve was 0.84. All studies were found to have a high risk of bias and good applicability. Meta-analysis showed: National Institutes of Health Stroke Scale score, age, neutrophil-to-lymphocyte ratio, neglect, visual impairment and atrial fibrillation were independent predictors of post-stroke delirium.

Conclusion

The included studies all found to have a high risk of bias; future studies should focus on adopting more scientifically rigorous study designs and following the standardised reporting guidelines to enhance extrapolation and facilitate its clinical application.

Implications for the Profession

This review may promote clinical healthcare workers to develop and update clinically available prediction models, thereby establishing risk prediction models with strong clinical utility.

Impact

This study presents the first systematic evaluation of delirium risk prediction models in stroke patients, thereby facilitating the choice, use and develop of the clinical usable post stroke delirium risk prediction models.

Reporting Method

This review adhered to the PRISMA guidelines.

Patient or Public Contribution

No patient or public contribution.

Review Registration

RD42024620360 (PROSPERO According to JAN Guidelines).

Current Status and Influencing Factors of Death Preparedness in Advanced Cancer Patients Based on the PRECEDE‐PROCEED Model: A Cross‐Sectional Study

ABSTRACT

Background

Death preparedness is an important prerequisite for improving the quality of life and the quality of death in advanced cancer patients. However, research on the level of death preparedness in patients is insufficient, and there is little understanding of the current status and influencing factors of death preparedness in advanced cancer patients.

Aim

This study aims to assess the current status of death preparedness and its influencing factors in advanced cancer patients.

Methods

Based on the PRECEDE-PROCEED model, a structured survey questionnaire was designed to collect data on personal factors (such as gender, age and residence area), interpersonal factors (such as social support, caregiver readiness and healthcare worker readiness) and social factors (such as care resources, policy support and information supply). Through multiple linear regression and BP neural network analysis, the study explores the impact and significance of these influencing factors on death preparedness in advanced cancer patients.

Results

A total of 930 valid questionnaires were collected in this study. The death preparedness score in advanced cancer patients was 72.18 ± 22.82, indicating a moderate level, with the highest score being the ‘reflexive care’ dimension and the lowest score being the ‘hospice programme’ dimension. Multivariate analysis revealed that meaning in life and social support were the most significant predictors of death preparedness in advanced cancer patients. In addition, personal factors such as dignity, household income and coping style, also played an important role. Interpersonal factors like social support, as well as social factors such as care resources and policy support, also had an impact on patients' death preparedness to some extent.

Conclusion

Death preparedness in advanced cancer patients is generally at a moderate level, and death preparedness is influenced by a combination of personal factors, interpersonal factors and social factors.

Impact

This study is based on the PRECEDE-PROCEED model to comprehensively explore the influencing factors of death preparedness in advanced cancer patients. It provides theoretical support for improving life services for advanced cancer patients. It offers valuable practical experience and insights for societal attention and reform in end-of-life care.

Patient or Public Contribution

No Patient or Public Contributions were included in this paper.

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